anxiety

Posted on ADHD

Survey finds 25% of adults suspect they have undiagnosed ADHD

Medication

Allison Burk takes medication to manage ADHD. She was diagnosed with the condition as an adult, which resolved years of unanswered questions about issues with focus and impulsivity that affected every area of her life. (Credit: The Ohio State University Wexner Medical Center)

Attention deficit/hyperactivity disorder, also known as ADHD, is often considered to be a condition that affects children. However, more adults are coming to the realization that their difficulties with attention, focus, and restlessness might be due to undiagnosed ADHD. This increased awareness is partly thanks to the popularity of social media videos that have garnered millions of views.

According to a new national survey of 1,000 American adults commissioned by The Ohio State University Wexner Medical Center and College of Medicine, 25% of adults now suspect that they may have undiagnosed ADHD. However, only 13% of the survey respondents have shared their suspicions with their doctor. This has raised concerns among mental health experts.

That’s raising concerns about the consequences of self-diagnosis leading to incorrect treatment.

“Anxiety, depression, and ADHD can often appear similar, but providing the wrong treatment can exacerbate the situation rather than improving the individual’s well-being and functionality,” stated psychologist Justin Barterian, PhD, who serves as a clinical assistant professor at Ohio State’s Department of Psychiatry and Behavioral l Health.

An estimated 4.4% of people ages 18 to 44 have ADHD, and some people aren’t diagnosed until they’re older, Barterian said. 

“There is definitely more awareness of how ADHD can continue to affect individuals into adulthood. Many people are realizing, once their kids have been diagnosed, that they also exhibit these symptoms, as it is a genetic disorder,” Barterian said.

The survey found that younger adults are more likely to believe they have undiagnosed ADHD than older generations, and they’re also more likely to do something about it. 

Barterian said that should include seeing a medical professional, usually their primary care provider, to receive a referral to a mental health expert to be thoroughly evaluated, accurately diagnosed and effectively treated. 

“If you’re watching videos on social media and it makes you think that you may meet criteria for the disorder, I would encourage you to seek an evaluation from a psychologist or a psychiatrist or a physician to get it checked out,” Barterian said.

What is Adult ADHD?
Adults struggling with ADHD will have problems with paying attention, hyperactivity and impulsivity that are severe enough to cause ongoing challenges at school, work and home. These symptoms are persistent and disruptive and can often be traced back to childhood.

Adult ADHD occurs in:

  • Adults who were diagnosed as children, but symptoms continue into adulthood.
  • Adults who are diagnosed for the first time, despite experiencing symptoms since they were younger that had been ignored or misdiagnosed.

Hyperactivity as a symptom is typically less present in adults than in children. Many adults with ADHD struggle with memory and concentration issues. Symptoms of ADHD often worsen with stress, conflict or increased demands in life.

What are common types of ADHD?
The three types of ADHD are:

  • Inattentive ADHD – Inability to pay attention and distractibility. This also is known as attention-deficit disorder (ADD).
  • Hyperactive and impulsive ADHD – Hyperactivity and impulsivity.
  • Combined ADHD – This type causes inattention, hyperactivity and impulsivity.

ADHD can be challenging to diagnose in adults because some symptoms overlap with those of other mental health conditions, such as depression or anxiety.

“Symptoms of ADHD can look different between different people,” Barterian said. “Some people might have more difficulty focusing on lectures or with organization, while others may have more social difficulties with impulsivity and trouble following along in conversations.”

Posted on ADHD, Autism

Neurons look different in autistic children

Neuronal measurements could provide new insight into diagnosis and therapeutic interventions for autism
Neuronal measurements could provide new insight into diagnosis and therapeutic interventions for autism

New evidence suggests that the cells responsible for communication in the brain may have different structures in children with autism. Researchers at the Del Monte Institute for Neuroscience at the University of Rochester have found that neuron density in certain areas of the brain varies in children with autism compared to the general population.

“We have spent many years describing the broad characteristics of brain regions, such as thickness, volume, and curvature,” said Zachary Christensen, MD/PhD candidate at the University of Rochester School of Medicine and Dentistry, and the first author of the paper published today in Autism Research. “However, newer techniques in the field of neuroimaging for characterizing cells using MRI reveal new levels of complexity throughout development.”

Imaging provides new insight into brain development

Researchers analyzed brain imaging data from over 11,000 children aged 9-11. They compared brain scans of 142 children with autism to those of the general population and found lower neuron density in certain regions of the cerebral cortex. These regions are associated with memory, learning, reasoning, and problem-solving. On the other hand, they also found increased neuron density in the amygdala, a region responsible for emotions. The researchers compared the brain scans of children with autism not only to those without any neurodevelopmental diagnosis but also to a large group of children diagnosed with common psychiatric disorders like ADHD and anxiety. The results indicated that these differences are specific to autism.

“People diagnosed with autism often have to cope with other conditions such as anxiety, depression, and ADHD. These findings indicate that we now have a new set of measurements that show promise in identifying individuals with autism,” Christensen explained. “If we can reliably and easily identify unique differences in neuron structure in those with autism, it opens up opportunities to understand how autism develops. These measures could also be used to identify individuals with autism who may benefit from more targeted therapeutic interventions.”

Technology leverages what we know about the inner workings of the brain and autism

The advancement of technology has greatly improved the ability of investigators to observe precise details in neuronal structure. In the past, researchers could only observe structural differences in neural populations after death. The imaging data for this research was obtained from the Adolescent Brain Cognitive Development (ABCD) study database, which is the largest long-term study of brain development and child health. The University of Rochester is one of 21 national sites collecting data for this study, which began in 2015 and has significantly enhanced our understanding of adolescent brain health and development.

Posted on ADHD, Mental health

Specially designed video games may benefit mental health of children and teenagers

Johns Hopkins Children’s Center researchers reviewed studies of video games designed as mental health interventions for anxiety, depression and ADHD
Johns Hopkins Children’s Center researchers reviewed studies of video games designed as mental health interventions for anxiety, depression and ADHD.

In a review of previous studies, a Johns Hopkins Children’s Center team concludes that some video games created as mental health interventions can be helpful – if modest – tools in improving the mental well-being of children and teens with anxiety, depression and attention-deficit/hyperactivity disorder (ADHD).

An estimated 20% of children and teenagers between the ages of three and 17 in the U.S. have a mental, emotional, developmental or behavioural disorder. Suicidal behaviours among high school students also increased by more than 40% in the ten years before 2019, according to a report by the Agency for Healthcare Research and Quality. Other studies provide evidence that the COVID-19 pandemic’s disruptions worsened these trends, and while research suggests parents and other care givers are seeking out mental health care for children, wait times for appointments have increased.

“We found literature that suggests that even doubling the number of pediatric mental health providers still wouldn’t meet the need,” says Barry Bryant, M.D., a resident in the Department of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine and first author of the new study.

In a bid to determine if so-called “gamified digital mental health interventions,” or video games designed to treat mental health conditions, benefited those with anxiety, depression and ADHD, the research team analyzed their use in randomized clinical trials for children and adolescents.

Bryant and child and adolescent psychologist Joseph McGuire, Ph.D., identified 27 such trials from the U.S. and worldwide. The studies included 2,911 participants, about half of whom were boys and half of whom were girls, between the ages of six and 17.

The digital mental health interventions varied in content, but were all created with the intent of treating ADHD, depression and anxiety. For example, for ADHD, some games involve racing or splitting attention, which requires the user to pay attention to more than one activity to succeed in gameplay. For depression and anxiety, some of the interventions taught psychotherapy-oriented concepts in a game format. All games were conducted on technology platforms like computers, tablets, video game consoles and smartphones. The video games are available to users in various ways — some are available online, while others required access through specific research teams involved in the studies.

Outcome measurements varied depending on the study. However, the Johns Hopkins research team was able to standardize effect sizes using a random-effects model so that a positive result was indicated when interventions performed better than control conditions. Hedges g, a statistic used to measure effect size, was used to quantify treatment effects overall in the studies reviewed.

Researchers also examined factors that led to improved benefit from digital mental health interventions. Specific factors related to video game delivery (i.e., interventions on computers and those with preset time limits) and participants (i.e., studies that involved more boys) were found to positively influence therapeutic effects. Researchers say these findings suggest ways to improve the current modest symptom benefit.

“While the benefits are still modest, our research shows that we have some novel tools to help improve children’s mental health — particularly for ADHD and depression — that can be relatively accessible to families,” says Joseph McGuire, PhD, an author of the study and an associate professor of psychiatry and behavioural sciences in the school of medicine. “So if you are a paediatrician and you’re having trouble getting your pediatric patient into individual mental health care, there could be some gamified mental health interventions that could be nice first steps for children while waiting to start individual therapy.”

Posted on ADHD, Autism, Mental health, Neurodiversity

Beyond labels: A new framework for neurodiversity and mental health

A new article introduces a dimensional approach to understanding the mental health needs of neurodivergent people
A new article introduces a dimensional approach to understanding the mental health needs of neurodivergent people.

A groundbreaking article published in the leading psychiatry journal World Psychiatry challenges the traditional approach to diagnosing neurodivergent conditions (also known as “neurodevelopmental disorders” in the medical literature), such as autism, ADHD, and learning disabilities. The research introduces a new transdiagnostic that views these conditions as points on a spectrum rather than distinct categories and recognizes their frequent overlap with mental health challenges, such as depression and anxiety. 

Around 15% of the global population is neurodivergent, often experiencing multiple conditions at the same time. Current diagnostic systems, such as the DSM-5 and ICD-11, separate these conditions into distinct categories or “labels,” overlooking their shared characteristics and complex interplay. Dr Giorgia Michelini, a Lecturer in Psychology at the Queen Mary University of London, is leading an international group of experts in the field to propose a more holistic approach that focuses on the commonalities among these conditions.

“Dr. Michelini stated, ‘By acknowledging the common features of neurodivergent conditions, we can gain a more precise and thorough understanding of their varied expressions. This fresh perspective has the potential to transform how we recognize, evaluate, and assist the mental health requirements of neurodivergent individuals.'”

The study introduces the concept of a “neurodevelopmental spectrum,” which encompasses the shared characteristics of various neurodivergent conditions. This approach acknowledges that individuals vary in the degree to which they exhibit these characteristics, allowing for a more nuanced and personalized assessment. It also provides a better way to identify and support additional mental health challenges, which affect the majority of neurodivergent people.

“Dr. Michelini explained that moving beyond rigid diagnostic labels will allow clinicians to provide more personalized support and interventions for the diverse range of difficulties experienced by neurodivergent individuals. By concentrating on an individual’s unique strengths and challenges, we can enhance their overall well-being and quality of life.”

This research represents a significant advancement in neurodiversity and mental health. Dr. Michelini’s work challenges the status quo and offers a fresh perspective, with the potential to transform the lives of millions of neurodivergent individuals.

Posted on Autism

Understanding Anxiety in Autistic Children

Studies show that 85% of autistic children experience anxiety, but the connection between the two conditions is still unclear. Research led by Dr. Emma Duerden from Western University aims to explore the brain’s intricacies to enhance our understanding of the relationship between anxiety and autism. The goal is to improve care for neurodiverse children and their families.